Folic Acid Supplementation and Spontaneous Preterm Birth: Adding Grist to the Mill?

Callaway, Leonie K.; Colditz, Paul B.; Fisk, Nicholas M.

doi:10.1371/journal.pmed.1000077

Cited by 20 publications

(13 citation statements)

References 19 publications

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“…The early initiation of folic acid supplementation could characterize women that planned a pregnancy but did not become pregnant during the first months, thus including a subgroup of sub-fertile women [35]. In MoBa, the women were asked to report the number of months with regular intercourse without contraception before becoming pregnant, and these data were classified as follows: <1 month (n = 12,912, 20%), 1–2 months (n = 14,818, 23%) and >2 months (n = 21,883, 33%).…”

Section: Resultsmentioning

confidence: 99%

“…However, the Hungarian RCT, one of the biggest performed so far, did not find any effect of a high dosage of 8000 μg/d of folic acid supplementation on PTD [6]. Unfortunately, the folic acid dosage was not indicated in all of the studies [21,35]. …”

Section: Discussionmentioning

confidence: 99%

“…However, the same association of the early initiation of folic acid supplementation and spontaneous PTD was found in primi-gravidae. Folic acid supplementation starting more than 8 weeks prior to conception might characterize women who planned a pregnancy but did not become pregnant during their first 2 cycles, thus constituting a subgroup of women with suboptimal fertility [35]. The same association of the early start of supplementation was found in the group of women that became pregnant within the first month.…”

Section: Discussionmentioning

confidence: 99%

“…In some countries like Greece and Norway, commonly used supplements contain folic acid and/or iron only [20]. In other countries, folic acid is mainly consumed in the form of multivitamins, making it difficult to differentiate the effects of multivitamin use and folic acid supplementation [21,35,41,48]. Vitamins other than folic acid might explain the association between multivitamin use and PTD.…”

Section: Discussionmentioning

confidence: 99%

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Retracted: Folic acid supplementation, dietary folate intake during pregnancy and risk for spontaneous preterm delivery: a prospective observational cohort study

Sengpiel

Bacelis

Myhre

et al. 2013

BMC Pregnancy Childbirth

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BackgroundHealth authorities in numerous countries recommend periconceptional folic acid to pregnant women to prevent neural tube defects. The objective of this study was to examine the association of folic acid supplementation during different periods of pregnancy and of dietary folate intake with the risk of spontaneous preterm delivery (PTD).MethodsThe Norwegian Mother and Child Cohort Study is a population-based prospective cohort study. A total of 65,668 women with singleton pregnancies resulting in live births in 1999–2009 were included. Folic acid supplementation was self-reported from 26 weeks before pregnancy until week 24 during pregnancy. At gestational week 22, the women completed a food frequency questionnaire, which allowed the calculation of their average total folate intake from foods and supplements for the first 4–5 months of pregnancy. Spontaneous PTD was defined as the spontaneous onset of delivery between weeks 22+0 and 36+6 (n = 1,628).ResultsThe median total folate intake was 266 μg/d (interquartile range IQR 154–543) in the overall population and 540 μg/d (IQR 369–651) in the supplement users. Eighty-three percent reported any folic acid supplementation from <8 weeks before to 24 weeks after conception while 42% initiated folic acid supplementation before their pregnancy. Cox regression analysis showed that the amount of folate intake from the diet (hazard ratio HR 1.16; confidence interval CI 0.65-2.08) and from the folic acid supplements (HR 1.04; CI 0.95-1.13) was not significantly associated with the risk of PTD. The initiation of folic acid supplementation more than 8 weeks before conception was associated with an increased risk for PTD (HR 1.19; CI 1.05-1.34) compared to no folic acid supplementation pre-conception. There was no significant association with PTD when supplementation was initiated within 8 weeks pre-conception (HR 1.01; CI 0.88-1.16). All analyses were adjusted for maternal characteristics and socioeconomic, health and dietary variables.ConclusionsOur findings do not support a protective effect of dietary folate intake or folic acid supplementation on spontaneous PTD. Pre-conceptional folic acid supplementation starting more than 8 weeks before conception was associated with an increased risk of PTD. These results require further investigation before discussing an expansion of folic acid supplementation guidelines.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Retracted: Folic acid supplementation, dietary folate intake during pregnancy and risk for spontaneous preterm delivery: a prospective observational cohort study

Sengpiel

Bacelis

Myhre

et al. 2013

BMC Pregnancy Childbirth

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show abstract

“…This answer is clear as extended below. Certainly, the major obstetric diseases of preterm labour, preeclampsia and foetal growth restriction are still treated ineffectively, often in an atmosphere of therapeutic nihilism (Callaway et al 2009). The second question is whether, if such products became available, they would impact visibly on maternal and perinatal mortality.…”

Section: Approaches To Reduce Maternal and Perinatal Disease Burdenmentioning

confidence: 99%

Relative and absolute addressability of global disease burden in maternal and perinatal health by investment in R&D

Fisk

Atun

2011

Tropical Med Int Health

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Summary Maternal and perinatal disease accounts for nearly 10% of the global burden of disease, with only modest progress towards achievement of the Millennium Development Goals. Despite a favourable new global health landscape in research and development (R&D) to produce new drugs for neglected diseases, R&D investment in maternal/perinatal health remains small and non‐strategic. Investment in obstetric R&D by industry or the not‐for‐profit sector has lagged behind other specialties, with the number of registered pipeline drugs only 1–5% that for other major disease areas. Using a Delphi exercise with maternal/perinatal experts in global and translational research, we estimate that equitable pharmaceutical R&D and public sector research funding over the next 10–20 years could avert 1.1% and 1.9% of the global disease burden, respectively. In contrast, optimal uptake of existing research would prevent 3.0%, justifying the current focus on health service provision. Although R&D predominantly occurs in high‐income countries, more than 98% of the estimated reduction in disease burden in this field would be in developing countries. We conclude that better pharmaceutical and public sector R&D would prevent around 1/3 and 2/3, respectively, of the disease burden addressable by optimal uptake of existing research. Strengthening R&D may be an important complementary strategy to health service provision to address global maternal and perinatal disease burden.

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Probiotics for preventing gestational diabetes

Barrett¹,

Nitert²,

Conwell³

et al. 2012

Cochrane Database of Systematic Reviews

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Folic Acid Supplementation and Spontaneous Preterm Birth: Adding Grist to the Mill?

Abstract: Nicholas Fisk and colleagues discuss a new study reporting that additional voluntary folic acid supplementation was associated with a major reduction in very preterm births.

Cited by 20 publications

References 19 publications

Retracted: Folic acid supplementation, dietary folate intake during pregnancy and risk for spontaneous preterm delivery: a prospective observational cohort study

Retracted: Folic acid supplementation, dietary folate intake during pregnancy and risk for spontaneous preterm delivery: a prospective observational cohort study

Relative and absolute addressability of global disease burden in maternal and perinatal health by investment in R&D

Probiotics for preventing gestational diabetes

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